Evidence map›Paper›PMID 39687081›Full record

ArticleBrain & spine2024

The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction?

R D Singh, M W H Bolscher, J T J M van Dijck, R J G Vreeburg, I A M van Erp, V Lubrano, G C W de Ruiter, B Depreitere, S C Cannegieter, B Siegerink and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brain & spine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

R D SinghDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.
M W H BolscherDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.
J T J M van DijckDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.
R J G VreeburgDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.
I A M van ErpDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.
V LubranoService de Neurochirurgie, Hôpital de Rangueil, CHU de Toulouse, 1, Avenue Du Professeur-Jean-Poulhès, Toulouse, France.
G C W de RuiterDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.
B DepreitereNeurosurgery, University Hospitals Leuven, Leuven, Belgium.
S C CannegieterDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
B SiegerinkDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
T A van EssenDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.
W C PeulDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: In 1960, Lazorthes and Campman introduced the concept of a Research question: This study aimed to analyze posttraumatic intracranial pressure (ICP) patterns in a large European cohort to investigate the existence of a third-day crisis and its impact on 12-month functional outcomes. Materials and methods: Data were analyzed from the prospective Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Patients with TBI admitted to ICUs in 65 European centers who received ICP monitoring were included. ICP measurements, averaged per day, were analyzed using mixed models. The association between ICP peak timing and functional outcome was examined with multivariable logistic regression. Results: The study included 886 patients. Average ICP trajectories showed no significant changes over the first seven days post-injury, without elevation around the third day. Among 563 patients with ICP >20 during the first week, 45% reached their highest ICP after the third day. Elevated ICP (>20 mmHg) during the first week was associated with unfavorable 12-month outcomes, but the timing of ICP peak was not linked to functional outcomes. Discussion and conclusion: This multicenter study challenges the 'crisis of the third day' concept. No distinct ICP or TIL elevations were observed around the third day. Elevated ICP remains a prognostic indicator, but ICP peak timing does not correlate with functional outcomes.

Indexed as

Intracranial pressureNeurosurgeryTherapy intensity levelTraumatic brain injury

Identifiers

PMID39687081
PMCPMC11647161

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.